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DR. IVGENIJA FASTOVSKY M.D.

Psychiatry >> Psychiatry & Neurology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1043455645

Individual Registrant:
DR. IVGENIJA  FASTOVSKY M.D.
Gender: F
Sole Proprietor

Location and contact information for practice:
19111 COLLINS AVE APT 2505  SUNNY ISLES BEACH, FL 33160-2384 US
Tel: 305-933-6873  Fax: 305-933-6873

Contact information for business:
19111 COLLINS AVE APT 2505  SUNNY ISLES BEACH, FL 33160-2384 US
Tel: 305-933-6873  Fax: 305-933-6873

Registration Information:
NPI: 1043455645
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2084P0800XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
Psychiatry
FLME 59109
Y2084P0805XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
FLME 59109

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICARE GHIP 55311NY01
00580525NY05




HEALTH CARE JOBS FL - Page 1



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